The Show Must Go On

An Update on Clinical Experiences and Clinical Studies on Novel Pharmaceutical Developments for the Treatment of Atopic Dermatitis

Tatjana Honstein; Thomas Werfel

Disclosures

Curr Opin Allergy Clin Immunol. 2020;20(4):386-394. 

In This Article

Conclusion

During the last years, a number of promising new substances for the treatment of atopic dermatitis were developed. For dupilumab, which was the first antibody approved for the treatment of moderate-to-severe atopic dermatitis, recent 'real world data' from registries confirm efficacy and safety. Novel antibodies address cytokine type 2 targets like IL-13 or IL-31 with promising results published from larger phase 2 studies. Additional proof-of-concept studies showed possible efficacies of anti-TSLP, anti-IL-22 or anti-IL-33 antibodies but here confirming larger phase II studies are needed. Oral drugs for the treatment of atopic dermatitis are highly welcome particularly for the younger population suffering from the skin disease. The histamine-4 receptor antagonist adriforant showed efficacy in a proof-of-concept study and a couple of JAK inhibitors have already been studied with success in larger phase II or even phase III studies. So far, no increased risk of viral airway infections was noted in controlled phase II or phase III studies of novel systemic drugs for atopic dermatitis – however, generally phase II and phase III studies may be underpowered to detect rare adverse effects of new drugs. Therefore, real world data generated in registries after their approval are highly needed.

It is important that also new topicals for the atopic dermatitis are developed. The topical PDE4 inhibitor crisaborole, which is so far approved in the USA for the treatment of atopic dermatitis is mildly effective. Both tapinarof, a modulator of the aryl hydrocarbon receptor, and topical JAK inhibitors are currently being examined in clinical studies with promising results and possibly stronger efficacy in atopic dermatitis.

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